Mast Quadrant微创系统下腰椎单侧固定椎间融合术的疗效对照研究

Clinical effect of lumbar unilateral fixed intervertebral fusion via Mast Quadrant minimally invasive system

目的探讨MastQuadrant微创系统下腰椎单侧固定椎间融合术的可行性和有效性。方法对2010-05—2012-05在该院接受MastQuadrant微创系统下腰椎单侧固定椎间融合术22例（微创单侧组）和接受开放腰椎双侧固定椎间融合术25例（开放双侧组）作疗效对比观察。结果微创单侧组的切VI长度、手术时间、术中出血量、术后住院时间和术后伤口疼痛持续时间均少（短）于开放双侧组（P均〈0．01）。术后1年疗效评估，微创单侧组的13本骨科学下腰痛评分系统（JOA）评分高于开放双侧组（P〈0．01），视觉模拟评分法（VAS）评分低于开放双侧组（P〈0．01）。两组椎间隙高度、椎间融合率比较差异无统计学意义（P〉0．05）。结论MastQuadrant微创系统下腰椎单侧固定椎间融合术与传统开放腰椎双侧固定椎间融合术相比，在恢复椎间隙高度、提高椎间融合率、重建腰椎稳定性方面具有同样的临床效果，而微创单侧固定椎间融合术更具有手术创伤小、手术时间短、术后恢复快、并发症少等优点。

Objective To discussed the feasibility,validity and effect of lumbar unilateral fixed intervertebral fusion via Mast Quadrant minimally invasive system. Methods From May 2010 to May 2012,in our hospital,there were 22 patients undergoing surgery of lumbar unilateral fixed intervertebral fusion via Mast Quadrant minimally inva- sive system （the minimally invasive and unilateral fixed group）, and 25 patients undergoing open surgery of lumbar bi- lateral fixed intervertebral fusion （ the open and bilateral fixed group）. Results In these respects such as length of in- cision, time of operation, intraoperative blood loss, postoperative hospitalization duration and postoperative wound pain duration, the minimally invasive and unilateral fixed group was superior to the open and bilateral fixed group（ all P 〈0. 01 ）. One year after operation,the Japanese orthopeadic association（JOA） scores was higher and visual analog scale（VAS） scores was lower in the minimally invasion and unilateral fixed group than the open and bilateral fixed group（ all P 〈 0. 01 ）. While in the height of intervertebral space and the intervertebral fusion rate there was no statis- tically significant difference between the two groups （P 〉 0. 05 ）. Conclusion The surgery of lumbar unilateral fixed intervertebral fusion via Mast Quadrant minimally invasive system and the surgery of lumbar bilateral fixed interverte- bral fusion have same clinical effects in recovery of intervertebral space height,increasing of intervertebral fusion rate and reconstruction of lumbar spinal stability. However, the minimally invasive and unilateral fixed intervertebral fusion has advantages of less operative wound, shorter operative and hospitalizing time, more rapid recovery and fewer com- plications.